Hiperidrose compensatória após simpatectomia toracoscópica: características, incidência e influência na satisfação do paciente

Hyperhidrosis is an idiopathic condition characterized by excessive sweating. Symptoms generally begin in childhood or early adolescence, and rarely improve with age. The excessive localized sweating generally occurs either spontaneously, or in association with stressful or emotionally charged situations. This prospective study aimed to investigate predictive factors for compensatory hyperhidrosis after thoracoscopic sympathicotomy. From 2000 to 2002, 80 patients (53 female and 27 male) underwent hyperhidrosis surgery. The patients, ranging from 12 to 56 years old, were studied and followed-up for 42.51 ±5.98 months. A satisfaction grading using a visual analogue scale -VAS (0 = not at all satisfied, and 10 = fully satisfied) was used. The surgical procedure was performed bilaterally on the second ganglion (T2) for facial hyperhidrosis, on the third and fourth ganglia (T3 and T4) for axillary hyperhidrosis, and on the third ganglion (T3) for palmar hyperhidrosis. The results showed that, 68 patients (85%) presented with compensatory sweating (CS), which was classified as mild (33.8%), moderate (33.8%) and severe (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, while 10 patients (12.5%) were dissatisfied. Degrees of satisfaction varied according to sex, age, BMI and extent of denervation. Moreover, the compensatory hyperhidrosis was more severe in abdomen and back than in legs. In conclusion, although CS is a frequent adverse effect of sympathicotomy, the degree of patient satisfaction was high. Some factors were related to the occurrence and severity of CS and the most adequate patients to be submitted to this operation are young adult women whose BMI is less than 24.9

PLANFOR: política compensatória para a inclusão na informalidade?

Study about the national politics on the professional education, under responsibility of the brazilian Work Department in 1990 years. Purposes to apprehend the results of the actions of the professional education in a basic level, offered by the National Plan of the worker qualification ( PLANFOR ), as well as the effects on the assisted exits, starting from the experience appreciated on the Plan of Qualification developed in the state of Maranhão between 1996 to 2000. It adopts a theoretical-methodological conception by an ontological nature, if being worth of categories as the one of totality and of mediation that together, makes possible the apprehension of a dialectical movement that happens among the analysis object, the professional education politics in a basic level, performed by PLANFOR and your context, the underdevelop and heterogeneous Brazilian capitalism and the consequent job market generalized precarious and informal, making possible that the reality investigated become to understood rationally. This paper uses the indirect documentation technique, instruments of the bibliographical research and documental research. This study is based on those that aren´t part of PLANFOR, qualified by professional education courses in basic level,they didn't get to be inserts at the formal job market, just occupying precarious occupations in the informal job market. Aims to presents and discusses the productive process and your restructuring globally in progress. It focuses at the impacts on the workers, the precariousness of the work that appears like a new phenomenon calls new informality. Talks about the particularity process of productive restructuring assumed in Brazil highlights, showing that the informality, was always a structural phenomenon in the country. Discusses about the professional qualification in the contemporary capitalism, specifying some of your theses. Shows in a historical view the process of appearance of the employment notions and competence, and the influence that it exercised on the reforms of the basic and professional education, as well as the implications of both in the politics of professional education in the country. Rescues the process of creation of PLANFOR, your official formulations and your organized bases, starting from the second half of the 1990 decade. Shows yet the continuos changes in the job market of Maranhão state, for after, starting from the reports expresses at the Plans of Qualification from the state, elaborated by the Group of Evaluation and Studies of the Poverty and the Politics addressed to the poverty from the Master degree Program in Public Politics, from the Federal University of Maranhão, analyzing the acting of PLANFOR in the State, your probable deficiencies, as results the changes verified in the conditions of occupation and the gains of the exits from the professional education courses in basic level

Efeitos da senescência no folheto intergeniculado do tálamo de ratos: análises morfológicas e neuroquímicas

The circadian timing system (CTS), in rodents, consists of interconnected neural structures such as the suprachiasmatic nucleus (SCN) of the hypothalamus, Intergeniculate Leaflet (IGL) of the thalamus, synchronous pathways and behavioral effectors. The SCN has been described as the major circadian pacemaker in several species of mammals, while the IGL appears to be involved in integration of photic and non-photic clues relaying them to SCN. The CTS allows an ordered internal temporal organization to the organism, providing the proper execution of physiological and behavioral mechanisms, which brings homeostasis. However, this stability is disrupted with aging process causing numerous pathological disorders, ranging from simple loss of physiological functions to decreases in cognitive performance. Therefore, is fundamental understanding the effects of senescence in this system. In this context, is proposed in this study to check if there are changes in IGL cytoarchitecture, neurochemical and retinal afferent markers with aging and their possible morpho-functional implications. To achieve this goal wistar rats were divided into 3 groups: young (3 months); Middle Age (13 months); Old (23 months). They were submitted to paraformaldhyde (4%) transcardiac perfusion to tissue fixation. Then, they had their brain removed and sectioned in 30 µm slices, which every sixth section were collected. This sections were processed by nissl method and immunostaining for GFAP, GAD, ENK, NPY and CTb in order to analyze the IGL features. It was observed a cell loss in middle age and old animals at Nissl, NPY and CTb stains. In addition, it was shown a increase in GFAP in middle aged animals compared to young and old ones. No differences were found in other neurochemichal stains. These data suggests IGL loss retinal afferents and neurons, in special the NPY-IR ones, likely having a compensatory gliogenesis. This supports the correlations between the CTS functional deficits and an anatomical deterioration of its components with the aging process.